Phases of Womanhood is honored to welcome Dr. Marie Anderson, of the Tepeyac Family Center. Dr Anderson will be writing a regular "Q & A" column, and she welcomes your questions about pregnancy, childbirth, menopause and all aspects of women's health!

Dr. Anderson is a board certified OB-Gyn who practices at the Tepeyac Family Center with Dr. John Bruchalski.  She has affiliations with the Couple to Couple League and is active on the Bioethics Committee at Fair Oaks Hospital where she practices. She founded the Kristen Anderson Perinatal Hospice Center, in honor of her deceased daughter, as part of Tepeyac in 2004. She is a popular speaker in the Washington area having appeared on local television and at local schools, colleges, and universities where she has spoken about pertinent medical issues as they relate to life.

Dear Dr. Anderson,  I hear so many conflicting views on the new Gardasil vaccination to protect against the HPV virus. Should I vaccinate my 13-year old daughter?

Dear Dr. Anderson, I am 25 and engaged to be married.  I have not had sex but my fiancé had sex with two other women before he met me.  Should I get the HPV vaccine?

Dr. Anderson: You’ve both raised important concerns shared by many other women. Please do talk with you own doctor, but let me offer some points to consider as you decide what’s best.

Gardasil protects women against the human papilloma virus (HPV), which causes cervical cancer and genital warts.  HPV is the most common sexually transmitted virus in the United States and has about 40 different strains. It infects more than 50% of men and women at some time in their lives.

How do you get it?  Through sexual contact including, but not limited to, sexual intercourse.  In other words, a women (or teen) who has sexual genital contact with an infected man may still get HPV, even if she does not actually have intercourse.  Even women who have abstained from premarital sex and are in a monogamous marriage may still be at risk from HPV if the woman’s spouse had sexual relations before marriage. Most couples are not virginal when they marry. And the reality is that 10-25% of women report being victims of unwanted sexual contact at some point in their lives. So many women will in fact become exposed to the HPV virus, either unwittingly or unwillingly.

Because HPV causes such serious health problems (two of the four most common types of HPV cause 70% of all cervical cancers, while the other two most common types cause 90% of genital warts.), women need to protect themselves from HPV.  What’s the best protection? Without a doubt, abstaining from sex before marriage, marrying someone else who also has abstained, and remaining faithful in marriage are the only foolproof ways to avoid an infection with HPV. Women also may benefit from the HPV vaccine, Gardasil, proven to protect against the four most common types of HPV. Gardasil offers women protection against unexpected exposure to HPV and the resulting risk of genital warts and most kinds of cervical cancer.

Does the very real protection afforded by the vaccine mean that every woman (and every teen) should rush out and get it? Not necessarily. Some risks and complications have been reported since the vaccine was approved for use and national distribution began in June 2006. The Centers for Disease Control and Prevention and the FDA track health problems voluntarily reported following vaccinations. According to the Journal of the American Medical Association (8/18/2009), 772 of the vaccine-related reports, or about six percent, have been classified as "serious" -- including 32 reported deaths. Further, it is not fully clear how many years the vaccine will provide effective protection for a woman.  Thus a young teen who receives the vaccine may actually become unprotected—and require repeat vaccination--during the very years when she is at greater risk of contracting HPV. Because of these reasons, my practice (Tepeyac Family Center) does not endorse general use of this vaccine for all women in the recommended age groups.  We instead suggest that every woman discuss her personal risks with her doctor in order to make an informed decision.   Check out our website and read more about this.


What questions do you have for Dr. Marie Anderson? Let's hear from all you ladies out there!  Please comment--even anonymously--below!

*If you prefer to ask a question privately, please send your question to AsktheDoctor@phasesofwomanhood.org.  We cannot promise that all questions will be answered.

**This information in this column is of a general nature and is provided for informational and entertainment purposes only.  It does not create a doctor-patient relationship, nor is it intended to replace or substitute for professional or medical advice related to any individual’s specific concerns. All liability for any action or decisions by any person following the general information in this column is expressly disclaimed. Please see our website policies for more information.

Great Article - thank you. I do have a question; "Because of these reasons, my practice (Tepeyac Family Center) does not endorse general use of this vaccine for all women in the recommended age groups." Can you please tell me at what age you are advising the vaccine be given? I could not find that on your website. My daughter is 13 1/2 and we have held off on this vaccine.

Dr. Anderson, this is so helpful. I am raising six daughters and have had so many questions about this new vaccine. Thank you for clarifying some of my concerns. I intend to pass this on to several friends. I'd love to see you address everything related with menopause. I am just starting this new phase in my life and have so many concerns and questions.

Thank you!

Can you please tell me if it is possible to pass HPV to infants in utero. Thank you!

Dear Dr. Anderson,

I have a question. I am a mom of a large family(more than 6 kids) and am almost 45. I have had heavy periods for the last few years and this past summer I had to receive a blood transfusion and iron IV infusions over the summer because I am losing so much blood and was severely anemic. There are not any Catholic doctors in my area. I am a practicing Catholic. The options that have been provided to me are: 1. the pill - I tried this for one month abstaining during my fertile time; it made me feel horrible. 2. Oblation- I don't want to do a procedure that would require anesthesia if I don't have to 3. Mirena - IUD with progesterone; this is what my doctor is recommending and I would abstain during my fertile time. I would love to hear your advice, thank you!

In an ideal world, if the child and then adult would never come in contact with anyone who would be carrying the virus, then the vaccine would not be needed. We do not live in an ideal world. This is a decision that should be made by the parents. When the child becomes 18, becomes sexually active, is engaged to be married, etc., the decision should be revisited. The decision concerning the 13-year-old girl must be incorporated into the larger question which is, "If I am going to have my daughter vaccinated, when should that happen?" The answer lies within the parental prerogative, and should be based on factors such as the maturity of the child, and the perspective of the supporting information that is relayed to the 13-year-old. This is an opportunity to reinforce the "chastity talk" that makes clear this vaccination does not give license to irresponsible behavior. Keep in mind that nobody can predict the future, especially future sexual behavior, and unfortunate events such as rape or infidelity. Once a woman is exposed to any of the strains of HPV, the vaccination cannot protect her from that strain nor can it treat her for it. Parents know best the timing of this vaccination should they chose to give it to their daughter.

Hi Dr. Anderson, Im so happy to see you all the time I remember you and I give thanks for control my pregnancy and to received my beautiful Baby Mady she is 22 months now..Congratulations you are the best..


yessenia, Ecuador

Comment: Dr. Anderson, this is so helpful. I am raising six daughters and have had so many questions about this new vaccine. Thank you for clarifying some of my concerns. I intend to pass this on to several friends. I'd love to see you address everything related with menopause. I am just starting this new phase in my life and have so many concerns and questions.



Glad to hear this was helpful! One of the best resources for a concise discussion of premenopause, perimenopause, and menopause is The Art of Natural Family Planning Premenopause Student Guide, Couple to Couple League 2009. Whether or not you are familiar with fertility awareness, this excellent book covers everything from pertinent definitions and hormones, to changes in fertility signs, to pregnancy, to strategies for dealing with the variety of symptoms that may cause discomfort; it even includes a chapter on marital intimacy during this stage of life. There are also numerous self-help tips in the 4th edition of Fertility, Cycles & Nutrition which includes an entire chapter on premenopause, perimenopause, and menopause. Both of these books can be purchased at the DMC Pharmacy (www.dmcpharm.com) or through the Couple to Couple League (www.ccli.org).

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